CARRYING CONCEALED DEADLY WEAPONS ARMED FORCES HANDGUN TRAINING AFFIDAVIT Affiant, first being duly cautioned and sworn, avers under oath and under penalty of perjury as follows: 1. My name is (please print): ; 2. I have applied for a Carry Concealed Deadly Weapons (CCDW) license from the Department of Kentucky State Police (KSP); 3. My CCDW Application Number is: ____________________________________; 4. My social security number is: - - ; 5. My date of birth is: ___________________________; 6. I am an honorably discharged service member in the United States Army, Navy, Marine Corps, Air Force, or Coast Guard, or a reserve component thereof, or of the Army National Guard or Air National Guard, and I have met one or more of the training requirements listed below: a. Successfully completed handgun training which was conducted by the United States Army, Navy, Marine Corps, Air Force, or Coast Guard, or a reserve component thereof, or of the Army National Guard or Air National Guard; or b. Successfully completed handgun qualification within the United States Army, Navy, Marine Corps, Air Force, or Coast Guard, or a reserve component thereof, or of the Army National Guard or Air Force National Guard. 7. I am aware and agree that the information provided herein may be verified by KSP with the United States Department of Defense and its military departments, and/or other appropriate government agencies, and I authorize the release of any records by these entities to KSP for verification purposes. Further Affiant sayeth naught. _______________________________________________________________________ Affiant Signature STATE OF ____________________________ COUNTY OF __________________________ Sworn to, acknowledged, and subscribed before me by Affiant, this ______ day of _______________, 20____. __________________________________________________ Notary Public State At Large My commission expires: ______________________________ KSP 136 Revised 9/14 .